In February 2019, a team of occupational therapists from KK Women’s and Children’s Hospital (KKH) flew to Jakarta, Indonesia, to conduct a three-and-a-half-day workshop for 36 special education (SPED) practitioners from 10 local institutions for children with special needs.

No ordinary workshop, it marked the ground-breaking inauguration of a four-year partnership between Singapore Health Services (SingHealth), Singapore International Foundation (SIF) and Foundation for the Development of Children with Special Needs (YPAC) Jakarta, aimed at enhancing educational support for children with special needs in Jakarta.

Over four years, the KKH team aims to provide occupational therapy training for 50 SPED practitioners from YPAC Jakarta and other local institutions, with the potential to benefit an estimated 1,750 children with special needs and their families. From the cohort of training participants, a core team of 20 master trainers will receive additional training to cascade their knowledge to others in the field.

STRENGTHENING SUPPORT FOR CHILDREN WITH SPECIAL NEEDS

“Currently, the majority of children with special needs in Indonesia are enrolled in special or inclusive schools,” shares Ms Soh Siok Khoon, Head and Principal Occupational Therapist, Occupational Therapy Service, KKH, who also leads KKH’s involvement in the SingHealth-SIF-YPAC partnership.

Based on a KKH study trip to Jakarta in 2017, visiting key institutions for children with special needs, the main clinical conditions observed in the children included cerebral palsy, intellectual disabilities and developmental disabilities.

“From an occupational therapy perspective, four areas have been identified that could benefit from improvement: staff knowledge and skills in the management of children with special needs; frequency and access to intervention by children with special needs; availability of training opportunities for staff; and interdisciplinary communication and collaboration in the management of children with special needs,” Ms Soh adds.

“Our aim is to begin the task of upskilling the staff at the various institutions for children with special needs, building their clinical skills and knowledge, and equipping them to deliver evidence-based therapeutic interventions, strategies and tools.

“To accommodate resource and manpower limitations, developing a trans-disciplinary mindset and approach is also vital to optimising the children’s access to and frequency of intervention.”

EMPOWERING EDUCATORS WITH EVIDENCE-BASED SKILLS

The inaugural workshop in February was attended by a wide range of SPED practitioners, including occupational therapists, physiotherapists, speech therapists, special education teachers and institutional-based caregivers.

Training was conducted along two parallel tracks for generalists and specialists. Along the generalist track, all training participants were equipped with tools and strategies to adopt an integrated approach in the management of children with special needs – such as a common language to communicate about students’ needs, goals and plans; universal intervention strategies; and tools for assessing students’ performance of school-based occupations, classification of student’s functioning levels, and facilitating basic activities of daily living, such as showering, feeding, grooming and toileting.

A smaller cohort of master trainers was identified to participate in the specialist track, where they received further equipping to cascade the training to other healthcare and education professionals, and caregivers.

“Special needs education is collaborative and interdisciplinary in nature. Bridging the understanding between SPED practitioners on childhood occupations, and helping them to establish a common language to communicate about the children’s needs, goals, and plans, is absolutely crucial to the seamless delivery of care and intervention,” says team member, Ms Jo Chen, Principal Occupational Therapist, Occupational Therapy Service, KKH.

“The hands-on training methods of workshops and case study discussions provided valuable opportunities for the participants to share cross-disciplinary perspectives, learn from one another, and establish networks of support. It is heartening to see that this first workshop has provided a common platform for the different SPED professions to come together and work in concert toward this common, shared vision,” adds team member, Ms Foo Ce Yu, Principal Occupational Therapist, Occupational Therapy Service, KKH.

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​(Front row centre) KKH occupational therapists, Ms Foo Ce Yu, Ms Jo Chen and Ms Emily Ong at the launch ceremony of the Occupational Therapy for Children with Special Needs programme, together with representatives from SIF and YPAC Jakarta.

GEARING UP FOR LONG TERM, POSITIVE OUTCOMES

Over the next four years, the KKH team aims to conduct ongoing training, with a focus on clinical skills training to facilitate the performance of children with special needs in childhood occupations beyond the basic activities of daily living. These include facilitating handwriting performance, managing attention and behaviour issues, and facilitating play in children with special needs.

“To address key clinical conditions such as cerebral palsy, intellectual disabilities and developmental disabilities, the master trainers will also be provided more in-depth clinical skills training in sensory integration and neurodevelopmental treatment, to build their capabilities to provide more effective individual therapy to students with more significant needs,” says team member, Ms Emily Ong, Occupational Therapist, Occupational Therapy Service, KKH.

Other training components will emphasise the development and enhancement of management tools and strategies; professional sharing via a symposium; and public education for patients and their caregivers to increase awareness of patient care requirements.

Seeking to benefit a wider community, the training programme will continue to work along a train-the-trainer model, with the aim of cascading skills and knowledge taught to wider groups of SPED practitioners and caregivers of children with special needs in Indonesia.

“In our role as allied health professionals, we have seen evidence that early intervention and support for children with special needs makes all the difference for their developmental growth. Empowering the children and the community enables long-term support and positive outcomes. It then becomes even more meaningful to be able to share and exchange knowledge and experience with our Indonesian friends,” says Ms Soh.

“We hope that the training programme will be a key catalyst in upskilling and bridging understanding and communication between the professions and institutions involved, to enable robust and accessible interprofessional care and education to be delivered more effectively for Jakarta’s children with special needs.”